For years the term failure to thrive has been used to describe infants that can not gain weight as well as reach certain physical...

by Kimberly Allen, RN

For years the term failure to thrive has been used to describe infants that can not gain weight as well as reach certain physical and cognitive development. However, as our population ages and medical care costs go up more and more older adults are developing failure to thrive. As many as 35% of older adults living in a community setting are suffering from failure to thrive in the US. In older adults living in nursing homes that number increases to as many as 40% with the number of hospitalized veterans having the highest number of older adults suffering from failure to thrive with as many as 60%. The statistics indicate there are more older adults suffering from failure to thrive in the US than in other developed countries. Including Europe which has only 15% of older community living adults suffering from failure to thrive.
Though the term failure to thrive is used for both pediatric and older adults there is a difference. Infants with failure to thrive have not reached their expected level of functioning where as in older adults the term means they are unable to maintain their level of functioning. Failure to thrive has been described by the National Institute of Aging as a “syndrome of weight loss, reduced appetite and poor nutrition, and inactivity, often accompanied by dehydration, depressive symptoms, impaired immune function and low cholesterol.” Failure to thrive is not a natural part of aging, though it’s prevalence increases with age and it has been associated with high morbidity and mortality rates in older adults.
There is no one cause that leads to failure to thrive in older adults. Experts believe there are numerous factors that contribute to the development of failure to thrive in older adults. Though malnutrition is a key factor in failure to thrive in older adults there are also a variety of medical conditions that can lead to someone developing failure to thrive as an older adult. Older adults with chronic infections or chronic inflammatory diseases as well as those on certain medications and those with psychiatric conditions like depression or Alzheimer’s disease tend to have a greater chance of developing failure to thrive. These various conditions all effect different organs creating a variety of mental, and physical as well as nutritional and metabolic disorder which in turn leads to the development of failure to thrive.
Elderly adults with symptom’s of failure to thrive should be evaluated by a doctor. In order to make a diagnosis of failure to thrive the doctor will require a complete and accurate medical history including when the symptoms were first noticed. The doctor will also run other tests to determine the underlying cause. treating the underlying cause is key to the effectiveness of treatment whether it’s malnutrition or depression if you don’t treat the cause the failure to thrive will not only fail to resolve it may worsen.
Many older adults living on their own have family member checking on them to be sure they are OK. So frequently it’s a family member that notices the weight loss first and they start to watch more closely for signs that something is wrong. If you or someone you know are concerned about an older adult in your life there are a few things you can do to help. Check any medications that your loved one may be taking, what are their side effects, do they interact with other medications and is your loved one taking them correctly. Keep an eye on their diet are they really eating or just telling you they are eating? Encourage your loved one to add supplements, like Ensure, to their diet. One of the reasons many older adults develop failure to thrive is they have little to no social interaction and their activity level is usually much lower. I know everyone gets busy but if it’s possible, taking your loved one for a walk or to the store can improve their social interaction as well as depression. It’s also good to encourage older adults to stay in touch with their friends and family either by calling or visiting when possible.

Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at mussatti3@gmail.com.